Q. Please explain where my symptoms are leading to.

Q. Please explain where my symptoms are leading to.

Questions

Hi doctor,

My symptoms over the last four months are as follows. I sat down on my mother’s bed and could not get up. I had severe pain in lower back on left side shooting down my leg. They felt like electric shocks and it lasted for a little over a week. During that time I had a lot of memory issues and I forgot my son’s birthday too. Three months back, I had an episode of double vision. Vision was double out of my right eye, but when I covered my left eye I could see. During this period, my head felt heavy. It only lasted for about five minutes and then got corrected by itself. The next day my eye was very sore. It started to hurt when I look from side to side. I had lot of flashing lights in my left eye that look like shooting stars on and off throughout the day. I just did not feel very good. I am having trouble finishing sentences. The thought just goes away and I forget what I am saying. The next day when I had laid down to rest I realized my left arm felt weird. It was numb and tingling from the shoulder down. I thought I would just take a nap and see if it got any better. I woke up at 5; still it was numb and tingling. Took a hot bath and got out but it remained the same. It felt as if I had rubbed icy hot all over it. It felt very cold to me, but not to touch. By the time I reached ER I was having trouble talking. I could not get my words from my head to my mouth. It was like they were getting stuck. I had CT scan done and laboratory tests all were normal. ER doctor recommended seeing a neurologist. I got an injection of Solu-Medrol. Immediately the following day I was stuttering and even my thoughts were stuttering, the more I tried not to the worse it got. Both hands started tingling and there was left leg tingling from the knee down. At night while I was lying on the couch I had excruciating pain on the left side of my face. My entire cheek felt like it was going to explode off my face. I took 800 mg Motrin. The pain lasted for about 45 minutes and just stopped. It did not gradually go away, just stopped. Then the next day, still felt off and very shaky. I felt hard to even type or text. I cannot focus on thoughts. I had very fuzzy head along with stuttering. My hands, feet, arms and legs still tingling on and off. I have started feeling my scalp tingle as well. Following day had very shaky hands. My hands hurt and felt weak. It felt like I have been holding onto something really tight and just let go. Still do not feel right. Glasses were not helping. Eye still hurts and still seeing flashes of light. Next day, I drank a very small amount of wine that was not even a full glass. Hands felt like they have been hit with a hammer and my scalp tingles so bad, it made my eyes squint and gave a horrible feeling. I have no energy. I feel so tired and could not even cook supper. My arm was too weak to brown hamburger meat. Head feels very strange like someone is pushing on the right side of my temple.

It is all still pretty much the same the following week. My scalp tingling, still stuttering, along with a lot of weakness in hands and arms. Left leg has started giving out on me and had fall in my living room. Black out when I stood up. I am still seeing flashes of light. Not sure what night this was but one night when I went to bed it was like my body had the hiccups and my arms and legs just kept jerking. I woke up feeling really bad. Head hurt, eyes hurt, hands and legs are still tingling. Still stuttering, sometime mid day I noticed my thoughts were no longer stuttering. The stuttering was gone. And slowly that day I started to feel better. No more tingling scalp, hands or feet. For the most part this is how it has been since. Thanksgiving I had a very small amount of wine again (not even a glass) and felt horrible again. Scalp tingling, body hurt and even fell into the wall. Other than a few little tingles here and the symptoms have stopped. No more flashes in eyes and no pain other than headaches. I am having some strange red and purple feet and hands. My hands hurt when they get cold. Feet and hands turn purple in the bath. Normal MRI with contrast. What should be the next step?

Answered

Hello,

Welcome to dr.sitehome.info.

These all symptoms could be unrelated but can be related too. In my opinion, you should be evaluated for multiple sclerosis.

A person with ALS (amyotrophic lateral sclerosis) or multiple sclerosis (MS) can have almost any neurological symptom or sign.

Autonomic, visual, motor and sensory problems are most common and may include loss of sensitivity or changes in sensation such as tingling, pins and needles or numbness, muscle weakness, pronounced reflexes, muscle spasms, ataxia, problems with speech or swallowing, visual problems, feeling tired and bladder and bowel difficulties.

So, the symptoms you are experiencing are just a small symptom of that, and we really do not suspect ALS in the first go on the basis of the symptoms you have mentioned.

In such scenario, you need to get tested for these. Get routine blood tests including thyroid profile, fasting blood sugar, calcium and vitamin D levels checked. If everything is normal, and the symptoms are pronounced, then we suspect ALS or MS.

The most commonly used diagnostic tools are neuroimaging, analysis of cerebrospinal fluid and evoked potentials. Magnetic resonance imaging of the brain and spine may show areas of demyelination.

The most important problem with MS is that it is disintegrated in time and space. It is not essential that you will have all the symptoms at the same time.

See your doctor. Get tested as we have discussed for the common causes.

If any issue is found then you will be treated for that, otherwise your doctor will wait and watch for any other symptoms. If they appear then your doctor will consider ALS or MS.